Magnetic Resonance Imaging in Urogynecology

True insight into the mechanisms underlying pelvic organ prolapse (POP), urinary incontinence, and fecal incontinence requires an appreciation of the pelvic anatomy, including the muscular and ligamentous mechanisms. MRI was generally used statically in specific situations, such as the investigation of urethral diverticula. MRI scanning uses strong magnetic fields and radio waves, without the involvement of ionizing radiation. There are many protocols for MRI scanning. MRI scan images are captured in a sequence of “slices,” taken in parallel along a line related to the scanned subject. Alterations in the vaginal shape can clearly be demonstrated in women with POP using MRI. The assessment of genito-urinary prolapse is based on the difference between the position of the lines passing through the landmark and perpendicular PCL in resting position and Valsalva's maneuver. Defecatory dysfunction and fecal incontinence may result in the presence of impaired support due to a rectocele or a deficient perineal body, or physical impedance as a consequence of POP.